How To Use CPT Code 50220

CPT 50220 describes the surgical procedure known as nephrectomy, which involves the removal of a kidney or part of a kidney. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50220?

CPT 50220 is used to describe the surgical procedure of nephrectomy, which involves the removal of a kidney or part of a kidney. This procedure is typically performed when the kidney is badly damaged or diseased and needs to be removed to improve the patient’s health. The surgery is performed under general anesthesia, and the physician makes an incision in the abdomen or flank to access the kidney. The kidney, along with the ureter and blood vessels, is disconnected and removed. The incision site is then sutured.

2. Official Description

The official description of CPT code 50220 is: ‘Nephrectomy, including partial ureterectomy, any open approach including rib resection.’

3. Procedure

1. The patient is placed under general anesthesia.
2. The physician makes an incision in the abdomen or flank, accessing the kidney.
3. The kidney, along with the ureter and blood vessels, is disconnected and removed.
4. If necessary, surrounding tissues such as the adrenal gland may also be removed.
5. The incision site is sutured.

4. Qualifying circumstances

CPT 50220 is used when a patient requires a nephrectomy procedure, which is the removal of a kidney or part of a kidney. This procedure is typically performed when the kidney is badly damaged or diseased and needs to be removed to improve the patient’s health. The procedure may involve the removal of the ureter and surrounding tissues, depending on the specific circumstances. It is important to note that CPT 50220 is specific to open approaches, including rib resection.

5. When to use CPT code 50220

CPT code 50220 should be used when a nephrectomy procedure is performed, including partial ureterectomy, using an open approach that involves rib resection. It is important to ensure that the procedure performed aligns with the specific details outlined in the official description of CPT 50220.

6. Documentation requirements

To support a claim for CPT 50220, the following documentation is required:

• Indication for the nephrectomy procedure
• Details of the specific approach used, including rib resection
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed, such as ureterectomy or removal of surrounding tissues
• Any complications or unexpected findings during the procedure
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 50220, it is important to ensure that the procedure performed aligns with the specific details outlined in the official description. Additionally, consider the following billing guidelines:

• Use CPT code 50225 if the same surgery has been performed on the same kidney in the past.
• Use CPT code 50230 if radical nephrectomy has been performed, involving the removal of the kidney, a section of the ureter, the adrenal gland, and surrounding fatty tissue.
• Use CPT code 50234 if nephrectomy was performed with total removal of the ureter and bladder cuff through the same incision.
• Use CPT code 50236 if nephrectomy was performed with total removal of the ureter and bladder cuff through separate incisions.
• Use CPT code 50240 if the physician only removed the diseased or infected portion of the kidney.

8. Historical information

CPT 50220 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including code changes in 2002 and 2010. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes a nephrectomy procedure to remove a severely damaged kidney.
2. A physician performs a partial nephrectomy, removing a portion of the kidney due to a localized tumor.
3. A patient with a history of kidney disease undergoes a repeat nephrectomy on the same kidney.
4. A radical nephrectomy is performed on a patient with advanced kidney cancer, involving the removal of the kidney, ureter, adrenal gland, and surrounding fatty tissue.
5. A nephrectomy is performed with total removal of the ureter and bladder cuff through separate incisions in a patient with recurrent kidney stones.